Changes in numbers of epidermal cell adhesion molecules caused by oral cyclosporin in psoriasis.
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Cell Adhesion Molecules↗
Biomedical subjects
L Jones
Publications and source records attributed to L Jones.
Mitoxantrone, chlorambucil and prednisolone in the treatment of non-Hodgkin's lymphoma.
The management of low grade lymphoma, both de novo and relapsed disease, is a contentious area in which there has been little real progress in recent years. Regimens which increase the intensity of treatment may accelerate the response but are inevitably associated with greater toxicity. This cannot be justified in a disease whose median survival is between 4 and 10 years and where the median age at presentation is 57. We have assessed the response of 144 patients treated with a combination of mitoxantrone, chlorambucil and prednisolone in a heterogeneous group with lymphoma, both de novo and relapsed disease. In the subgroup with low grade relapsed/refractory disease our results suggest that this combination is clinically effective, low in toxicity and suitable for the outpatient management of this usually elderly patient population.
Adult↗
Factors to be considered in devising an effective programme for the reduction of road traffic accidents.
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Accidents, Traffic↗
Coping with Serbian repression in an Albanian population.
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Albania↗
Protection of goats against peste des petits ruminants with a vaccinia virus double recombinant expressing the F and H genes of rinderpest virus.
Peste des petits ruminants (PPR) is a viral disease of goats and sheep characterized by necrotizing and erosive stomatitis, enteritis and pneumonia. The causative agent, PPRV, is a member of the family Paramyxoviridae and the genus Morbillivirus. Other members of the genus include rinderpest (RPV), measles, canine distemper and phocid distemper viruses. PPR has a very high rate of morbidity and mortality, and effective control of this disease is of economic importance in Africa, Asia and the Middle East. Currently, there is no safe and effective vaccine available against the disease. The tissue culture rinderpest vaccine (TCRV) protects small ruminants against severe disease; there are, however, clinical problems associated with vaccination. This laboratory has recently developed several effective vaccinia virus recombinant vaccines for rinderpest. These vaccines are easy to administer, inexpensive to produce and heat-stable. Goats were vaccinated with a vaccinia virus double recombinant expressing the haemagglutinin and fusion genes of RPV. Although vaccinated animals developed antibodies (neutralizing and ELISA) to RPV, and not to PPRV, they were completely protected against challenge inoculation with virulent PPRV. This would indicate that protection is most probably due to cell-mediated immunity. Use of the rinderpest double recombinant vaccinia virus in areas of the world where PPRV is endemic would aid in the control and eradication of PPR.
Animals↗
StORQS: Washington's Statewide Obstetrical Review and Quality System: overview and provider evaluation.
The Foundation for Health Care Quality (Washington) used three administrative public databases and indicators recommended by the Joint Commission and the American College of Obstetrics and Gynecology to build algorithms to measure quality of obstetric care in the state of Washington. Analyses demonstrated a high degree of variability across hospitals for major processes of care such as cesarean section, vaginal birth after cesarean section, and forceps deliveries. Eighty-five percent of the participating hospitals concluded that important aspects of care were being measured. Ninety-four percent found the information useful in describing their performance compared with other hospitals. Sixty-two percent believed the information was useful for initiating quality improvement projects. Of the 25 indicators tested in the project, indicators rated as most useful were the same 10 obstetric indicators chosen by the Joint Commission after alpha testing.
Cesarean Section↗
The histopathology of infrainguinal vein graft stenoses.
The precise histopathological nature of vein graft stenoses is unclear. Some authors have suggested that these lesions are due to intimal hyperplasia and others have claimed that they are fibrous strictures. The aim of this study was to determine the histological nature of infrainguinal vein graft stenoses by examining sections of vein grafts that had developed stenoses and had been surgically revised. This was performed using a combined anti-smooth muscle actin/Millers elastin stain. The results show that vein graft stenoses are due to intimal hyperplasia whereby smooth muscle cells proliferate and cause thickening of the intimal layer.
Aged↗
Asking effective questions: an important leadership role to support quality improvement.
Effective questions stimulate, guide, and empower employees to think critically about the improvement processes that they are involved in as team leaders or team members in their daily activities. Learn how questions must be carefully phrased in order to provide guidance and maintain the integrity of the team's ability to choose options and implement change.
Attitude↗
Costing medical libraries: the feasibility of functional cost analysis.
As a result of organizational changes in the National Health Service (NHS) there is a need for a coherent costing model for NHS libraries, particularly for the smaller libraries based in postgraduate medical centres. One possible model is functional cost analysis, whereby all costs are assigned to library functions representing services to users, such as loans from stock, interlibrary loans, enquiry services, etc. Using data from a 1991 survey of postgraduate centre-based libraries in the North West Thames (NWT) Region of the NHS, the feasibility and appropriateness of functional cost analysis is examined.
Budgets↗
Ambulatory care: a decade of change in health care delivery.
While the need to realign the continuum and change the delivery system is one of the many factors driving health care reform, it is clear that a major transformation of the delivery system is already under way and that ambulatory care and home care are at the forefront of that movement. This trend is likely to continue regardless of the pace of health reform.
Ambulatory Care↗
Recurrent right loin pain due to an accessory ureter.
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Adult↗
Immunological responses of mice and cattle to baculovirus-expressed F and H proteins of rinderpest virus: lack of protection in the presence of neutralizing antibody.
Rinderpest is a highly contagious viral disease of ruminants and has greater than 95% morbidity and mortality. The etiological agent, rinderpest virus (RPV), is a member of the family Paramyxoviridae and the genus Morbillivirus. Immune responses to both the hemagglutinin (H) and the fusion (F) antigens of morbilliviruses play an important role in the prevention of infection, and only attenuated live vaccines have been shown to provide protective immunity against the group. The lack of protection with inactivated vaccines has been attributed to the denaturation of the F glycoprotein of the virus. Our previous study, however, demonstrated complete protection of cattle vaccinated with infectious vaccinia virus recombinants expressing the H (vRVH) or F (vRVF) protein alone, even in the presence of only 4 U of serum-neutralizing (SN) antibody to RPV (T. Yilma, D. Hsu, L. Jones, S. Owens, M. Grubman, C. Mebus, M. Yamanaka, and B. Dale, Science 242:1058-1061, 1988). We have constructed recombinant baculoviruses that express the F (Fb) and H (Hb) glycoproteins of RPV. Furthermore, we have analyzed the immune responses of mice and cattle to these antigens. Cattle vaccinated with Fb or Hb or a mixture of both antigens were not protected from challenge inoculation with RPV, even when the SN titer was greater than in cattle vaccinated with vRVF alone. This lack of protection, in the presence of SN antibody, would indicate that live attenuated and recombinant vaccines induce immune responses necessary for protection (e.g., cell-mediated immunity) that are not generated by subunit or inactivated whole-virus vaccines.
Animals↗
Clonality of chronic neutrophilic leukaemia associated with myeloma: analysis using the X-linked probe M27 beta.
AIMS: To determine whether myeloid proliferation was monoclonal or polyclonal in a woman with chronic neutrophilic leukaemia and myeloma. METHODS: The X-linked probe, M27 beta was used to determine the clonality of the neutrophil population by analysis of restriction fragment length polymorphisms and X inactivation pattern. RESULTS: A polyclonal pattern of X inactivation was obtained for the neutrophil population in this patient. CONCLUSION: The myeloid expansion in chronic neutrophilic leukaemia associated with myeloma represents a polyclonal reactive response to the plasma cell clone rather than a co-existent myeloproliferative disorder.
Aged↗
Factors affecting response to an invitation to attend for a health check.
OBJECTIVE: To describe the characteristics of general practice patients who fail to respond to an invitation to attend for a health check, in relation to demographic variables, risk factor status, health status, and attitudes to behaviour modification. DESIGN: Postal questionnaire before invitation to attend a health check and subsequent record of attendance. SETTING: Five urban general practices in Bedfordshire, UK. SUBJECTS: A total of 2678 patients aged 35-64 years were invited for a health check in 1989-90. RESULTS: The number of patients who did not attend was low overall but was higher among men than women (21 v 15%, p < 0.001), and in unmarried than married patients (24 v 16%, p < 0.001). Failure to attend was also higher among people in manual than in non-manual occupations (21 v 15%, p < 0.001), in people living in rented accommodation than in homeowners (29 v 16%, p < 0.001), and in those without access to a car than in car users (27 v 16%, p < 0.001). There was no difference in non-attendance rate according to age at completion of full time education. After adjustment for age, sex, marital state, and social class, the odds ratio for non-attendance was 1.74 (95% confidence interval (CI) 1.41, 2.14) for smokers; 1.07 (95% CI 0.76, 1.51) for heavy drinkers; 1.91 (95% CI 1.41, 2.58) for those with a less healthy diet; and 1.50 (95% CI 1.09, 2.07) for those who were obese. Patients who had visited their general practice more frequently and those who indicated a willingness to change their behaviour were significantly more likely to attend the health check. CONCLUSIONS: Health check attendance was lowest among patients who rarely attended the surgery and those who reported higher risk behaviour. Attendance was not, however, confined to the 'worried well'. Equal numbers of those with and without chest pain attended, as did at least three quarters of those in each risk group. This high rate of attendance reflects the time and effort invested in systematic recruitment. The development of a robust recruiting strategy is essential if substantial numbers, and particularly those at highest risk, are to be reached.
Adult↗
The clinical rhombus revisited: learning through resistance and change.
Illustrates via the monitoring of an actual unit of Clinical Pastoral Education the reality of the clinical rhombus--a conceptual model that depicts the complex psychological and social nature of the learning environment. Shows how CPE supervisors utilize the clinical rhombus intentionally and unintentionally. Uses a case study to demonstrate the critical and creative possibilities for change when the rhombus is related to the project of pastoral formation.
Hospital Bed Capacity, 300 to 499↗
Megakaryoblastic leukemia presenting as a temporal bone granulocytic sarcoma. Case report.
The unusual presentation of acute megakaryoblastic leukemia as a temporal bone granulocytic sarcoma in an infant without systemic manifestations of leukemia is reviewed. Leukemia should be considered in the differential diagnosis of skull and skull-based lesions since the appearance on neuroradiological imaging is not unique in this diagnosis. Surgical treatment, as in this case, is limited to obtaining tissue for diagnosis and draining the infection.
Child, Preschool↗
Education and training: mission through total quality management.
Planning for 1994 to 1996 is underway with a focus on innovative, system-wide approaches to clinical and nonclinical quality improvement needs for FHSC's customers. TQM is a pivotal point in the system's future as a health care provider. As part of the TQM process, gaining knowledge and imparting it to employees is, in itself, a continuing journey.
Catholicism↗
General practice careers: changing experience of men and women vocational trainees between 1974 and 1989.
The aim of this study was to consider the careers pursued by men and women general practitioner trainees following the completion of their training, and to assess changes since 1974. It was based on a postal questionnaire survey involving 995 doctors who had completed general practice vocational training in the Oxford region between 1974 and 1989. A total of 796 doctors replied to the questionnaire (498 men and 298 women, overall response rate 80%). The vast majority of ex-trainees were working in general practice at the time of the survey (men 87%, women 71%). Women were less likely to have become principals than men (75% versus 97%). Most women (71% of those completing training before 1988) reported at least one period of non-employment. While the duration of maternity leave dropped only slightly during the 15 years studied, the length of voluntary and involuntary unemployment experienced by women fell markedly. Men experienced little unemployment with no change in length of unemployment over time. Considerably fewer women than men (6% versus 13%) had become involved in teaching or training. The degree of difficulty in choosing and following a general practice career remained constant over time for women. In contrast there was a significant increase in the difficulties experienced by men. The proportion of men and women completing training in 1984-89 who found following a general practice career 'difficult or very difficult' was similar (10% of men, 13% of women). The possibility of improving these experiences, particularly by encouraging flexibility in the early years after completion of training, is discussed.
Adult↗